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Effectiveness and Healthcare Cost of Adding Trastuzumab to Standard Chemotherapy for First-Line Treatment of Metastatic Gastric Cancer: A Population-Based Cohort Study
- Source :
- Cancers, Volume 12, Issue 6, Cancers, Vol 12, Iss 1691, p 1691 (2020)
- Publication Year :
- 2020
-
Abstract
- A randomized clinical trial showed that trastuzumab, added to traditional chemotherapy, significantly improved overall survival in human epidermal growth factor receptor 2 (HER2)-overexpressing metastatic gastric cancer patients. This population-based study aimed at evaluating both the clinical and economic impact of trastuzumab in a real-world setting. By using the healthcare utilization databases of Lombardy, Italy, a cohort of patients newly diagnosed with metastatic gastric cancer during the period 2011&ndash<br />2016 was selected. Among these, patients initially treated with either trastuzumab-based chemotherapy or standard chemotherapy alone were followed up until death, migration in other regions or June 2018. Overall survival and average cumulative costs were estimated and compared between the two treatment arms. Among the 1198 metastatic gastric cancer patients who started therapy within six months after metastasis detection, 87 were initially treated with trastuzumab-based chemotherapy and 1111 with standard chemotherapy. Median overall survival and restricted mean survival were 10.2 and 7.4 months, and 14.9 and 11.4 months, respectively, in the two treatment arms. The adjusted hazard ratio of death was 0.73 (95% CI 0.57&ndash<br />0.93). The average per capita cumulative healthcare costs were, respectively, EUR 39,337 and 26,504, corresponding to an incremental cost-effectiveness ratio of EUR 43,998 for each year of survival gained. Our study shows that adding trastuzumab to conventional chemotherapy is effective and cost-effective.
- Subjects :
- 0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
Cost effectiveness
medicine.medical_treatment
overall survival
Population
cost-effectiveness
gastric cancer
real-word evidence
trastuzumab
lcsh:RC254-282
Article
Metastatic gastric cancer
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Trastuzumab
law
Internal medicine
Medicine
education
skin and connective tissue diseases
Chemotherapy
education.field_of_study
business.industry
Hazard ratio
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
030104 developmental biology
Cost-effectivene
030220 oncology & carcinogenesis
Cohort
business
medicine.drug
Subjects
Details
- ISSN :
- 20726694
- Volume :
- 12
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Cancers
- Accession number :
- edsair.doi.dedup.....4e48e158696d6ceb096f047f5a3e5c3f